肾移植术后巨细胞病毒感染的诊断及治疗  

CYTOMEGALOVIRUS INFECTION IN RENAL TRANSPLANT RECIPIENTS

作　　者：马潞林[1] 管德林[1] 韩修武[1] 韩志友[1] 张愚[1] 许建军[1] 高居中[1] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院泌尿外科

出　　处：《肾脏病与透析肾移植杂志》1997年第6期539-541,共3页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的：介绍本单位对巨细胞病毒（ＣＭＶ）感染的诊断和治疗体会。方法：１９９６年５月至１９９７年５月我院共做肾移植８５例，其中７例发生ＣＭＶ感染，诊断主要依据发热、肺炎、神经根炎及视网膜炎等。实验室检查主要用ＰＣＲ方法测血、尿及眼分泌物中的ＣＭＶ－ＤＮＡ。胸片显示肺纹理增加。治疗主要用更昔洛韦，疗程１０～２４天。结果：７例中３例治愈，１例因ＣＭＶ感染诱发慢性排异反应，行移植肾切除，另３例均死于严重的肺炎。结论：肾移植术后ＣＭＶ感染应早期诊断及时治疗。OBJECTIVE Cytomegalovirus (CMV) infection is an major cause of death in renal recipients. In this article, we described our experience with CMV infection in renal transplant recipients.METHODOLOGY 85 patients who received renal transplant recipients between May 1995 and May 1997 were included in this study. Seven of these patients were diagnosed as CMV infected with the related clinical manifestation and positive PCR results for CMVDNA in the serum or the excretion.RESULTS The duration between the transplantation operation and the onset of CMV infection was between 1 to 7 months (the median was 4.4 months). Clinical manifestation of CMV infection in renal transplant recipients included fever, pneumonia, infection of the nervous system, retinitis gastrointestinal symptoms, decreased count of peripheral leukocyte and platelet. Chest X ray examination is important in the establishment of CMV pneumonia. With the use of intravenous Ganciclovir, 3 of the 7 cases with CMV infection were cured, 1 lost the renal graft because of the CMV infection mediated chronic renal rejection, other 3 died of CMV pneumonia.CONCLUSION Early diagnosis and treatment with Ganciclovir is important factors that influenced the survival of CMV infected renal graft recipients. 

关 键 词：肾移植 巨细胞病毒 诊断 治疗 感染 

分 类 号：R699.2[医药卫生—泌尿科学] R512.99[医药卫生—外科学]